Postgraduate Examinations Research Articles

Evaluation of Community Medicine Postgraduate Theory Examination to Measure the Content and Cognitive Domain CoverageA Retrospective Analysis

Introduction: Assessment is a critical step in learning process. Postgraduate theory examination ideally should assess higher levels of cognition. In order to maintain high standard of public health the postgraduates of the specialty should be certified properly using the appropriate assessment methods. Since the assessment drives learning, ideally it should be aimed at judging a learner’s attainment of curriculum outcomes. Aim: To evaluate the postgraduate theory exam question papers from 2014 to 2018 in Community Medicine (CM) of various South Indian Universities and to measure the actual content coverage as stated in National Medical Commission (NMC) curriculum and cognitive domain coverage as per Bloom’s taxonomy. Materials and Methods: The present retrospective analytical study was conducted from April 2019 to July 2019 to asses the question papers from 2014-2018 in community medicine. Sixty theory exam question papers (20 per University) of last 5 years of three South Indian Universities namely Pondicherry (PU), Tamil Nadu (TN), and Kerala (KR) of CM subject were analysed for content coverage and to categorise the level of knowledge assessed as per Bloom’s taxonomy. The significance of difference between the data of various years was tested using Chi-square test. Results: Questions testing higher cognitive domain was found only in 15%, 3.75% and 2.5% of PU, TN and KR universities, respectively. Epidemiology of communicable and noncommunicable diseases was the content that received maximum coverage of total marks, 25%, 21.25% and 18.5% in PU, TN and KR universities respectively. Certain topics were not covered in many papers. There was no statistical difference in distribution of marks among various Universities in South India. Conclusion: Findings of this study may be used to redefine the distribution of contents and cognitive domain tested across universities ensuring the validity and reliability of the assessment.

Exploration and Practice of Probability Theory Teaching Reform in Colleges and Universities

The subject of probability theory is widely established in colleges and universities. Probability theory is a very important subject, whether it is the usual final examination or many students' postgraduate entrance examination. This has certain requirements for the teaching of probability theory, but there are many problems in the teaching of probability theory in many colleges and universities, such as backward teaching methods and low requirements for students, which have greatly affected students' learning, and require college teachers to reform the teaching of probability theory. This paper will make some suggestions on how to reform the teaching of probability theory in colleges and universities.

Thoughts and Practice on Teaching Reform of Clinical Medical Undergraduate Interns under the Background of “Double Tracks in One”

By reforming the traditional teaching mode, and giving the inspection way, put forward the diversified and “classification guidance” mode of teaching, fully arouse the enthusiasm of students, help trainees to establish scientific research thinking, to achieve the goal of improving the effect of practice and increasing the success rate of postgraduate entrance examination, for the problems existing in the unity of “Double Tracks in One” policy solutions, for further training of high quality medical personnel to improve the basis.

Post-Graduate theory examination: Should we relook into the assessment tool?

In this editorial, I like to share some of my views and concerns regarding the MD-Community Medicine theory examination conducted by The West Bengal University of Health Sciences. Though this review focuses particularly on the Community Medicine speciality of the WBUHS, some of these may be relevant for other specialities and some other Universities as well. Opinions expressed here are based on my experiences as a paper-setter and examiner for MD examinations of the WBUHS and some other Universities for several years.

Predictive validity of A-level grades and teacher-predicted grades in UK medical school applicants: a retrospective analysis of administrative data in a time of COVID-19

ObjectivesTo compare in UK medical students the predictive validity of attained A-level grades and teacher-predicted A levels for undergraduate and postgraduate outcomes. Teacher-predicted A-level grades are a plausible proxy for...

Investigation and Analysis on the Postgraduate Entrance Examination for Undergraduate Students from Private Colleges and Universities

Students from private undergraduate universities were included in this study as research subjects. Questionnaires were distributed to the students to collect information in order to keep abreast of students’ motivation, preference, preparation and plan, encountered difficulties and adjustments made, demands, as well as other aspects about their postgraduate entrance examination. The results showed that students from private universities have clear motivation for their postgraduate entrance examination, but there are some problems, such as the lack of scientific choices, long preparation time, more challenges, and lack of school support. In view of these problems, this study offers countermeasures and suggestions for these students and relevant schools.

EP.TU.4Performance at Medical School predicts success in the Intercollegiate Membership of the Royal College of Surgery (MRCS) examination

Abstract Aims Identifying predictors of success in post-graduate examinations can help guide the career choices of medical students and may aid early identification of trainees requiring extra support to progress in specialty training. We assessed whether performance at medical school as quantified by the Educational Performance Measurement (EPM) and scores from the Situational Judgement Test (SJT) used for selection into Foundation Training predicted success at the Membership of the Royal College of Surgeons (MRCS) examination. Methods We analysed data from the UKMED Database for UK graduates who had attempted MRCS Part A (n = 1,975) and Part B n = 630) between 2013-2017. Univariate analysis examined the relationship between performance and the likelihood of passing MRCS at first-attempt. Logistic regression identified independent predictors of MRCS success. Results For every additional EPM decile point gained the chances of passing MRCS at first attempt increased by 52% for Part A (odds ratio 1.52 [95% confidence interval (CI) 1.46-1.60]) and 27% for Part B (1.27 [1.18-1.38]). For every point awarded for additional degrees in the EPM, candidates were 29% more likely to pass MRCS Part A first time (1.29 [1.12-1.48]). SJT score was not a statistically significant independent predictor of MRCS Part A or Part B success after adjusting for sociodemographic factors (P = 0.182 and P = 0.125 respectively). Conclusions This, the first study to investigate the relationship between medical school and success at a high stakes UK postgraduate surgical examination found that medical school performance deciles are the most significant measure of predicting later success in the MRCS.

SP2.2.4National multi centre cohort study of transferable skills acquired among redeployed core surgical trainees to intensive care units during the COVID-19 pandemic

Abstract Aim Due to the COVID-19 pandemic a large number of core surgical trainees have been redeployed to intensive care units across the country. This study analyses the procurement of transferable skills by trainees mapped to the ISCP curriculum among a large national cohort. Methods An anonymous questionnaire mapped to common areas in the ISCP syllabus, including basic sciences, post-operative care, critical care and management of the dying patient, was administered to a nationwide group of core surgical trainees redeployed to ITU. The results were compared with responses from a cohort of trainees that were not redeployed. Subgroup analysis was also performed on the redeployed cohort to compare skills before and after redeployment. Result A total of 72 complete responses from among 3 deaneries nationwide were received, 39 who were redeployed, and 33 who were not. Mean age (24.5 vs 24.9 years) and time post-graduation (37.5 vs 38.2 months) were similar in each group. The average length of redeployment was 12 ±0.157 weeks. The mean score in those not redeployed was 1.85 ±0.167, compared to 4.02±0.175 in the redeployed cohort (p < 0.05). Among those redeployed, scores prior to redeployment were significantly lower 1.89 ±0.122 (p < 0.05). Conclusion This study demonstrates that even a brief period of intensive care experience significantly increases knowledge of key aspects of the ISCP curriculum. It is the authors’ opinion that a module of intensive care experience during core surgical training should be considered. Our cohort will be followed to assess performance in postgraduate examinations.

EP.TU.6The Impact of Disability on Performance in the Intercollegiate Membership of the Royal College of Surgeons examination (MRCS)

Abstract Aims The number of medical students and doctors with disabilities is increasing, however there is a paucity of data on the performance of doctors with registered disabilities in the postgraduate environment. To address this gap in knowledge, we assessed the impact of disabilities on performance in the MRCS. Methods All UK medical graduates who had attempted MRCS Part A (n = 9,597) and Part B (n = 4,562) between 2007-2017 with linked disability data in the UK Medical Education Database (https://www.ukmed.ac.uk) were included. Univariate analysis identified associations with MRCS performance and logistic regression models identified independent predictors of success. Results Candidates with registered disabilities had lower MRCS Part A pass rates (46.3% vs 59.8% respectively (p < 0.001)) but similar Part B pass rates (68.2% vs 70.9% (p = 0.339). They were nearly twice as likely to fail Part A (odds ratio 0.55 [95% Confidence Interval 0.46-0.64]). When prior academic attainment (A-Levels and medical school performance) was taken into account, there was no statistically significant difference in the likelihood of success at MRCS (p > 0.05). MRCS pass rates were similar for candidates with specific learning difficulties and those with other registered disabilities p > 0.05). Conclusions This is the first study to assess the impact of disability status and type on performance at a postgraduate medical examination. It appears that candidates with registered disabilities perform less well in formal, written examinations generally. Our data indicate that the MRCS itself is fair for candidates with registered disabilities and that the current testing accommodations enable performance unrestricted by disability.

TP8.2.8 Medical School Selection scores correlate with MRCS Part A performance

Abstract Aims Selection into UK medical school involves a combination of three measures: prior academic attainment, selection tests (e.g. the University Clinical Aptitude Test (UCAT), Biomedical Admissions Test (BMAT), or Graduate Medical School Admissions Test (GAMSAT)) followed by interview. We investigated the predictive power of current UK medical selection tests and measures of prior attainment on success in the Membership of the Royal College of Surgeons (MRCS) examination. Methods The UKMED database was used to analyse A-Levels and medical school selection data for all UK graduates who attempted the MRCS Part A written examination (n = 9729) and Part B clinical examination (n = 4644) between 2007 and 2017. Univariate analysis and Pearson correlation coefficients examined the relationship between selection scores and first attempt MRCS success. Results Successful MRCS Part A candidates scored higher in A-Levels, UCAT, BMAT and GAMSAT examinations (p < 0.05) than their unsuccessful peers, but no differences were observed for MRCS Part B. Statistically significant positive correlation was found between MRCS Part A, BMAT (r = 0.32, p < 0.001) and GAMSAT scores (r = 0.35, p = <0.001). While a weaker statistically significant correlation was found between Part A, A-Level (r = 0.14, p < 0.001) and UCAT scores (r = 0.25, p < 0.001). Conclusions This, the first study to investigate the relationship between all UK medical school selection tests and success in a postgraduate examination found statistically significant correlations between selection test scores and performance on Part A of the MRCS. The strength of correlations found in this study are similar to those of other validated selection tests used in the United States.

BJS.02Graduates from different medical schools vary in their performance on the Intercollegiate Membership of the Royal College of Surgeons (MRCS) Examinations

Abstract Aims UK medical schools vary in their mission, curricula and pedagogy, but little is known of the effect of this on postgraduate examination performance. We explored differences in outcomes at the Membership of the Royal College of Surgeons examination (MRCS) between medical schools, course types, national ranking and candidate sociodemographic factors. Methods A retrospective longitudinal study of all UK medical graduates who attempted MRCS Part A (n = 9730) and MRCS Part B (n = 4645) between 2007 and 2017, utilising the UK Medical Education Database (https://www.ukmed.ac.uk). We examined the relationship between medical school and success at first attempt of the MRCS using univariate analysis. Logistic regression modelling was used to identify independent predictors of MRCS success. Results MRCS pass rates differed significantly between medical schools (P < 0.001). Russell Group graduates were more likely to pass MRCS Part A (Odds Ratio (OR) 1.79 [95% Confidence Interval (CI) 1.56-2.05]) and Part B (OR 1.24 [1.03-1.49])). Trainees from Standard-Entry 5-year programmes were more likely to pass MRCS at first attempt compared to those from extended (Gateway) courses, Part A OR 3.72 [2.69-5.15]; Part B (OR 1.67 [1.02-2.76]. Non-graduates entering medical school were more likely to pass Part A (OR 1.40 [1.19-1.64]) and Part B (OR 1.66 [1.24-2.24]) than graduate-entrants. Conclusion Medical school, course type and socio-demographic factors are associated with success on the MRCS. This information will help to identify surgical trainees at risk of failing the MRCS in order for schools of surgery to redistribute resources to those in need.

51 The Impact of Disability on Performance in the Intercollegiate Membership of the Royal College of Surgeons examination (MRCS)

Abstract Aim The number of clinicians with disabilities is increasing, however there is no data on the performance of doctors with registered disabilities in the postgraduate environment. If we are to ensure diversity and equality within the workforce, we must first identify whether attainment differences exist in markers of performance. To address this, we assessed the impact of disabilities on performance in the MRCS. Method All UK medical graduates who had attempted MRCS Part A (n = 9,597) and Part B (n = 4,562) between 2007-2017 with linked disability data in the UK Medical Education Database (https://www.ukmed.ac.uk) were included. Univariate analysis identified associations with MRCS performance and logistic regression models identified independent predictors of success. Results Candidates with registered disabilities (n = 635) had lower MRCS Part A pass rates (46.3% vs 59.8% (p < 0.001)) but similar Part B pass rates (68.2% vs 70.9% (p = 0.339)). They were nearly twice as likely to fail Part A (odds ratio 0.55 [95% Confidence Interval 0.46-0.64]). When prior academic attainment (A-Levels and medical school performance) was accounted for, there was no statistically significant difference in the likelihood of MRCS success (p>0.05). Pass rates were similar for candidates with specific learning difficulties and those with other registered disabilities (p>0.05). Conclusions This is the first study to assess the impact of disability status and type on performance at a postgraduate medical examination. It appears that candidates with registered disabilities performed less well in formal, written examinations generally. Although our data indicate that current MRCS testing accommodations are fair, enabling performance unrestricted by disability.

Does the structure of the medical consultation align with an educational model of clinical communication? A study of physicians’ consultations from a postgraduate examination

ObjectiveThis study examined whether the structure of consultations in which physicians were tasked with sharing information corresponded to the chronological stages proposed by an established educational model of clinical communication. MethodSeventy six simulated consultations from a postgraduate examination for general medical hospital physicians were transcribed verbatim and converted into diagrams showing consultation structure. All doctor-patient/relative talk was allocated into six phases: Initiating, Gathering information, Summary, Explanation, Planning and Closing, using the ‘communication process skills’ from the Calgary-Cambridge Guide to the Medical Interview. ResultsThe majority of consultations included four or five of the expected phases, with most talk (41–92%) in Explanation and Planning. There was no discernible consistency of structure across the consultations or in consultations from the same scenario. Consultations varied in the presence, sequential order, size, location and reappearance of phases. ConclusionsThe structure of consultations in this standardised setting bore little resemblance to the chronological order of phases predicted by an educational model. Practice implicationsEducational guidance and interventions to support patients in preparing for consultations need to take account of doctors’ behaviour in practice. Assumptions about the organisation of medical consultations should be queried in the absence of an evidence base.

Stress Factors among Dental Postgraduate Residents of Lahore, Pakistan

OBJECTIVES: 
 The aim of this study was to identify the stress factors among dental postgraduate residents of Lahore, Pakistan.
 METHODOLOGY: 
 A cross-sectional study was conducted using non-probability convenient sampling techniques. Total 150 dental postgraduate residents were enrolled in this study. Questionnaire was composed of questions regarding stress factors and the influence of stressors on individuals. The data was analyzed; Chi-square test was used to find the statistical association of level of stress with the demographic factors (gender, marital status, and accommodation), professional characteristics (working hours and practice) and impact on the individuals (mood change, weight change and headache). The level of significance was set at P≤0.05. 
 RESULTS: 
 Total 150 individuals responded with a mean age of 29 years (SD +/-2.96). Male to female ratio was 1:2.5. The most prevalent factors that contributed to stress were post-graduate examination (81%), clinical case presentations (80%), competition for higher performance (61%), inconsistency of feedback by supervisors (59%), research program (55%) and fear of failure to treat patients (53%). More than half of the respondents (69%) suffered from mood swings and (65%) from tension headaches followed by clenching and bruxism in nearly half of the residents (50%), musculoskeletal problems (49%) and weight changes (48%) with p-value<0.05. 
 CONCLUSION: 
 Post-graduate examination, competition for higher performance and increased workload are the most common stressors. There is a need to come up with effective strategies in the postgraduate curriculum to tackle stress.

Analysis on the Difference in the Initial Examination Results of Postgraduates Based on Regression Discontinuity Design

The high grades in postgraduates entrance examination are the stepping stone to improve the professional competition in China, which makes the critical influence factors to the initial examination of postgraduates as a hot topic. In order to measure the correlation between the academic performance of undergraduate students and the probability of successful postgraduate entrance examination, and find some effective ways to improve the success rate in the postgraduate entrance examination, we design regression discontinuity model to search the causal correlation between the preliminary entrance exam and CET-6 scores of candidates. Global parameter estimation and local non-parameter estimation were estimated respectively to improve the accuracy of model fitting. In addition, the validity and robustness of the experiment were tested by sensitivity analysis. The results show that the students who get better grades in college are more likely to have a positive effect in the preliminary entrance examination, and make the success rate of postgraduate entrance examination higher.

The impact of COVID-19 on the postgraduate exit examination in a clinical subject

The year 2020 world experienced the rise of a new pandemic COVID-19 beginning. It started in India in early March. Maharashtra state saw a lockdown from March 2020. It has affected all the aspects of life in India including economy, patient care and medical education. The whole working system of hospitals had to be changed and most of the hospitals were divided into COVID and non-COVID parts. This article is an effort to study the perceptions of postgraduate medical students in the department of medicine on the exit examination at the end of three years of residency in a medical college in Pune. Along with the postgraduate student’s perceptions, views of examiners are also studied under four aspects protective measures during examination, assessment of knowledge using case scenarios, student’s experience of case presentation without physical presence of patients and overall satisfaction with the novel method of examination.

Burnout in anaesthesiology residents: A systematic review of its prevalence and stressors.

Burnout is an occupational hazard precipitated by chronic exposure to excessive work-related stress. It can have negative impacts on the health and safety of patients and clinicians. Anaesthesiologists are at a high risk of burnout; anaesthetic residents especially may experience higher levels of stress as a result of training requirements and postgraduate examinations. However, the scale of burnout among anaesthesiology residents is not well evaluated. To determine the prevalence of burnout and identify risk factors contributing to it among anaesthesiology residents worldwide and evaluate preventive strategies at institutional and departmental levels. A systematic review without meta-analysis. We searched PubMed, Embase, Scopus and PsycInfo for English language articles published up to 24 May 2021. The inclusion criteria for qualitative analysis were a reported burnout prevalence in anaesthesiology residents and the use of an assessment tool. Exclusion criteria were reviews/meta-analyses/correspondence, non-English articles, articles without anaesthesiology residents and lacking information on burnout prevalence and metrics for assessment. Twelve studies met the inclusion criteria; seven studies utilised the 22-item Maslach Burnout Inventory Human Services Survey (MBI-HSS) and five utilised the abbreviated Maslach Burnout Inventory (aMBI). The reported burnout prevalence among anaesthesiology residents varied between 2.7 and 67.0% (median = 24.7%). Differences in burnout criteria contributed significantly to methodological heterogeneity. Factors predisposing to burnout included long working hours, poor workplace relationships, professional examinations and adverse clinical events. Protected rest time and restricted work hours were identified as effective strategies to prevent burnout. Other preventive strategies include mindfulness and resilience courses, as well as departmental initiatives such as exercise. Burnout is common amongst anaesthesiology residents. Standardised tools and diagnostic criteria are needed to distinguish methodological heterogeneity from true heterogeneity in study populations. Interventions have been proposed to improve management strategies to minimise burnout anaesthesiology residents. CRD42019140472.

A study of the factors affecting the academic performance of postgraduate examinees in the Master of Medicine (Anesthesiology) Part-1 examination

Background: It has been observed that some candidates do very well in postgraduate examinations and get through in the very first attempt, whereas the others may not do very well and have to go for multiple attempts to get through the same examination. This study aimed to determine the factors affecting the performance and the success rate in the first attempt in the Master of Medicine (Anesthesiology) Part–1 examination. Methodology: This was a cross-sectional study involving 73 postgraduate candidates who passed the Master of Medicine (Anesthesiology) Part–1 examination between 2016 and 2017. The candidates were required to respond to various questions about various factors assumed to be affecting their performance, including sociodemographic factors, pre–training, and in–training factors. Statistical analysis of the received responses was done and linked to the performance in the Part-1 examination. Results: The candidates with more than 5 y of medical service had 85% lower odds than those with 5 or fewer years (adjusted OR 0.15; 95% CI 0.03–0.81; p = 0.027). Those who passed the entrance examination after 2 or more attempts also had 80% lower odds than those who passed at the first attempt (adjusted OR 0.20; 95% CI 0.06–0.70; p = 0.011). The odds of the candidates who often had small-group discussions during their study leave were 16.21 times higher to pass than those who seldom had any discussion (adjusted OR 16.21; 95% CI 1.81–145.41; p = 0.013). Conclusions: The success in the Master of Medicine (Anesthesiology) Part–1 examination in first attempt was determined by a shorter duration of medical service, single attempt at the entrance examination, and regular small-group discussions. Key words: Anesthesiology; Postgraduate; Medicine; Examination; Candidate Abbreviations: UKM – Universiti Kebangsaan Malaysia; USM – Universiti Sains Malaysia; OSCE – Objective Structured Clinical Examination; SPM – Sijil Pelajaran Malaysia Citation: Yusoff ATM, Hassan WMNW, Hassan MH, Yusoff MSB, Shukeri WFWM, Yaacob NM. A study of the factors affecting the academic performance of postgraduate examinees in the Master of Medicine (Anesthesiology) Part-1 examination. Anaesth. pain intensive care 2021;25(4):478–486. DOI: 10.35975/apic.v25i4.1568 Received: April 16, 2021, Reviewed: May 30, 2021, Accepted: 2 June 2021

Does performance at medical school predict success at the Intercollegiate Membership of the Royal College of Surgeons (MRCS) examination? A retrospective cohort study

BackgroundIdentifying predictors of success in postgraduate examinations can help guide the career choices of medical students and may aid early identification of trainees requiring extra support to progress in specialty...

The impact of disability on performance in a high-stakes postgraduate surgical examination: a retrospective cohort study.

Despite rising numbers of doctors in the workforce with disabilities, little is known about the impact of disabilities on postgraduate performance. To ensure all groups are treated fairly in surgical training, it is essential to know whether any attainment differences exist in markers of surgical performance. To address this gap, we assessed the impact of disabilities on performance on the Intercollegiate Membership of the Royal College of Surgeons examination (MRCS). Retrospective cohort study. Secondary care. All UK MRCS candidates attempting Part A (n = 9600) and Part B (n = 4560) between 2007 and 2017 with linked disability data in the UK Medical Education Database (https://www.ukmed.ac.uk) were included. Chi-square tests and correlation coefficients established univariate associations with MRCS performance, while multiple logistic regressions identified independent predictors of success. Though MRCS Part B pass rates were similar (p = 0.339), candidates with registered disabilities had significantly lower first-attempt Part A pass rates (46.3% vs. 59.8%, p < 0.001). Candidates with disabilities also performed less well in examinations taken throughout school and medical school, and after adjusting for prior academic performance and sociodemographic predictors of success, logistic regression found that candidates with disabilities were no less likely to pass MRCS than their peers (odds ratio 1.04, 95% confidence interval 0.66 to 1.62). No significant variation was found in MRCS performance between type of disability or degree of limitations caused by disability (p > 0.05). Although candidates with registered disabilities performed less well in formal, written examinations, our data indicate that they are as likely to pass MRCS at first attempt as their peers who achieved similar grades at high school and medical school. In order to enable equity in career progression, further work is needed to investigate the causes of attainment differences in early career assessments.